Background & Statistics
Up to 13 million births worldwide are preterm. With such global incidence rates, over 130 million pregnancies (up to 10 million of who are at high risk) may potentially benefit from accurate cost-effective screening for preterm birth annually. Accurate prediction of risk by EIS may inform preventive clinical care. It may also improve decision-making regarding women who present in hospital with symptoms of preterm labour, as only 20% will deliver preterm, and >25% of in utero transfers to other hospitals for suspected preterm labour will remain undelivered after transfer. EIS may enable more prompt prevention, transfer to more appropriate care facilities and better surgical cervical support (cerclage) if insufficiency is better defined.
Several recent clinical reviews and executive summaries have highlighted the clear need for new/improved screening methods for preterm birth. Our series of studies – ECCLIPPxTM - is therefore highly timely. Currently, the most commonly used methods for screening for preterm birth are ultrasound cervical length (CL) and qualitative vaginal swab fetal fibronectin determinations. Both techniques have modest predictive values in high-risk women but have no cost-effective utility in unselected pregnant women in whom interventions based on CL alone are often unproductive. Progesterone treatment for at-risk women, cervical cerclage for proven cervical weakness, and the use of drugs to suppress preterm labour, can prolong gestation, but their utility for prevention of PTB has been restricted by a lack of accurate and prompt identification of women who may benefit.